Table of Contents
Introduction ............................................2
Section 1: General Classroom Behaviors...................5
Section 2: Physical Aggression (Series I)...............15
Section 3: Physical Aggression (Series II)..............25
Section 4: Verbal Behaviors (Series I)..................35
Section 5: Verbal Behaviors (Series II).................45
Section 6: Inattentive / Hyperactive Behaviors..........55
Section 7: Socially Withdrawn Behaviors.................65
Section 8: School Work-Related Behaviors................75
Section 9: Teacher-Selected Behaviors...................85
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Introduction Page 1
Introduction
The Purpose of This Resource Book.
The Classroom Behavior
Report Card Resource Book contains pre-formatted teacher and student behavior report cards, along with customized graphs, for common types of behavioral concerns in the classroom. It was designed to give teachers and other school professionals a convenient collection of forms for rating the behaviors of students in such areas of concern as physical aggression, inattention/hyperactivity, and verbal behaviors.
How to Select a Teacher Behavior Report Card.
Behavior Report
Cards are simple to use and can provide good information about student behaviors. When selecting a specific
Behavior Report Card, the instructor can get useful information each of the many pre-formatted cards in the Resource
Book by looking at the page header (see Figure 1).
Figure 1: Page Header Information
From left to right, the header indicates what class of behaviors the specific Report Card is designed to measure, who is to complete the card (teacher or student), how many times the card can be used (once for Daily cards, across a full week for Weekly cards), and the level of the card (Primary vs. Intermediate/Secondary).
Here are the steps to picking a Report Card
1.
The teacher selects one or more students in the classroom whose behavior they would like to track using a
Teacher Behavior Report Card.
2.
The teacher browses through the different behavioral 'sections' of the Resource Book and selects a preformatted Teacher Behavior Report Card that most closely matches the student behavioral concerns that they wish to measure. The major behavioral sections and their behaviors appear below:
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Section 1: General Classroom Behaviors
Section 2: Physical Aggression (Series I)
Section 3: Physical Aggression (Series II)
Section 4: Verbal Behaviors (Series I)
Section 5: Verbal Behaviors (Series II)
Section 6: Inattentive / Hyperactive Behaviors
Section 7: Socially Withdrawn Behaviors
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Section 8: School Work-Related Behaviors
Section 9: Teacher-Selected Behaviors (Blank forms with behavior goals to be filled in by the teacher)
3.
The teacher decides on the response format to use: Primary Level or Intermediate/Secondary Level. Primary
Level cards have 'smiley faces' in addition to numbers in the response block, a format that teachers may prefer if they need to share their ratings with younger students. The top item in Figure 2 is an example of the Primary
Level response format. Intermediate/Secondary Level cards have a number response format, but lack the
'smiley faces'. The bottom item in Figure 2 shows a completed Intermediate/Secondary Level example.
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Introduction Page 2
Figure 2: Different Response Formats
Primary Level Response Format
Intermediate/Secondary Level Response Format
4.
The teacher decides whether to use Daily or Weekly Report Cards . Daily cards can be used only once.
Weekly cards have blanks for teachers to write down their ratings across a full school week (see Figure 3).
Figure 3: Daily vs. Weekly Cards
Daily Report Card Weekly Report Card
Teachers may want to use the Daily card format as a convenient behavioral record to be sent home with the student for parents to review. If the teacher plans to keep the Behavior Report Card in the classroom, the
Weekly report format is a convenient format recording the student's behaviors across multiple school days.
5.
The teacher considers the option of having the student complete their own Behavior Report Card (Optional .
The Classroom Behavior Report Card Resource Book contains both teacher and student versions of all cards.
While use of student cards is optional, teachers may choose to assign these cards to students to use in a selfmonitoring program, in which the student rates their own behaviors each day. If teachers decide to use student behavior report cards, though, they should first identify and demonstrate for the student the behaviors that the
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Introduction Page 3 student is to monitor and show the student how to complete the behavior report card. Since it is important that the student learn the teacher's behavioral expectations, the instructor should meet with the student daily, ask the student to rate their own behaviors, and then share with the student the teacher's ratings of those same behaviors. The teacher and student can use this time to discuss any discrepancies in rating between their two forms. (If report card ratings points are to be applied toward a student reward program, the teacher might consider allowing points earned on a particular card item to count toward a reward only if the student's ratings fall within a point of the teacher's, to encourage the student to be accurate in their ratings.) NOTE: Student cards differ from teacher cards in that some of the student items have been slightly reworded so that young readers can more readily understand them. Student cards at the Primary level also have a simplified, 3-item response format with 'smiley faces' that students in earlier grades will find easy to complete.
Completing a Teacher Behavior Report Card.
Behavior Report Cards can be good sources of teacher information about student behaviors. However, most of the behavioral goals contained in this manual's Report Cards are general in focus. When a teacher's ratings on Report Cards are based solely on subjective opinions, though, there is a danger that the teacher will apply inconsistent standards each day when rating student behaviors. This inconsistency in assessment can quickly undermine the usefulness of report card data. One suggestions that teachers can follow to make it more likely that their report card ratings are consistent and objective over time is to come up with specific guidelines for rating each behavioral goal. For example, one item in the Verbal Behaviors I Teacher Report Card states that "The student spoke respectfully and complied with adult requests without argument or complaint." It is up to the teacher to decide how to translate so general a goal into a rubric of specific, observable criteria that permits the teacher to rate the student on this item according to a 9-point scale. In developing such criteria, the instructor will want to consider: l l l taking into account student developmental considerations. For example, "Without argument or complaint" may mean "without throwing a tantrum" for a kindergarten student but mean "without loud, defiant talkingback" for a student in middle school. tying Report Card ratings to classroom behavioral norms.
For each behavioral goal, the teacher may want to think of what the typical classroom norm is for this behavior and assign to the classroom norm a specific number rating. The teacher may decide, for instance, that the target student will earn a rating of 7
('Usually/Always') each day that the student's compliance with adult requests closely matches that of the
'average' child in the classroom. developing numerical criteria when appropriate. For some items, the teacher may be able to translate certain more general Report Card goals into specific numeric ratings. An item on the School Work-Related Behaviors
Teacher Report Card, for example, indicates as a goal that "The student was prepared for class, with all necessary school materials (e.g., books, pencils, papers). " The teacher may decide that the student is eligible to earn a rating of 7 or higher on this item on days during which instructional staff had to approach the student about lack of preparation no more than once.
Charting Report Card Ratings.
Teacher Report Card ratings can be charted over time to provide a visual display of the student's progress toward behavioral goals. Each Report Card series in this manual has its own chart, which permits the teacher to graph student behavior across up to 4 school weeks.
Figure 4: Behavior Report Card Chart Example
As Figure 4 illustrates, the instructor simply fills in the bubble each day that matches the numerical rating that they
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Introduction Page 4 assigned to the student for the specific behavioral goal. As multiple points are filled in on the graph, the instructor connects the points to create a time-series progress graph. When enough data points have been charted, the behavior graph can be used to judge the relative effectiveness of any strategies put in place to improve the student's behavior.
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 1: General Classroom Behaviors Page 5
Section 1: General Classroom
Behaviors
Target Behaviors: l l l l
Has difficulty getting along with other students in the classroom.
Does not always complete classwork assignments.
May be non-compliant when asked to complete adult requests.
Is unfocused or inattentive during academic tasks.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Teacher Daily Behavior Report Card Primary Level Page 6
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student got along with others while showing socially appropriate behaviors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed class assignments on time, applying his/her best effort.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student spoke respectfully and complied with adult requests without argument or complaint.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remained focused on the teacher or the assignment during class or work periods.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Teacher Weekly Behavior Report Card Primary Level Page 7
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student got along with others while showing socially appropriate
behaviors.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed class assignments on time, applying his/her best effort.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student spoke respectfully and complied with adult requests without
argument or complaint.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remained focused on the teacher or the assignment during class or work periods.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 8
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student got along with others while showing socially appropriate behaviors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed class assignments on time, applying his/her best effort.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student spoke respectfully and complied with adult requests without argument or complaint.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remained focused on the teacher or the assignment during class or work periods.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 9
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student got along with others while showing socially
appropriate behaviors.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed class assignments on time, applying his/her best effort.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student spoke respectfully and complied with adult requests without argument or complaint.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remained focused on the teacher or the assignment during class or work periods.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Behavior Rating Report Card Monitoring Chart Page 10
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Srudent Daily Behavior Report Card Primary Level Page 11
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I got along with others while behaving in a friendly and appropriate way.
1 2 3
Never/Seldom Sometimes Usually/Always
I completed class assignments on time, applying my best effort.
1 2 3
Never/Seldom Sometimes Usually/Always
I spoke respectfully to adults and followed their requests without arguing or complaining.
1 2 3
Never/Seldom Sometimes Usually/Always
I paid attention to my teacher or the assignment during class or work periods.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Srudent Weekly Behavior Report Card Primary Level Page 12
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I got along with others while behaving in a friendly and appropriate way.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I completed class assignments on time, applying my best effort.
1 2 3
Never/Seldom Sometimes Usually/Always
I spoke respectfully to adults and followed their requests without arguing or complaining.
1 2 3
Never/Seldom Sometimes Usually/Always
I paid attention to my teacher or the assignment during class or work periods.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Srudent Daily Behavior Report Card Intermediate/Secondary Level Page 13
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I got along with others while behaving in a friendly and appropriate way.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I completed class assignments on time, applying my best effort.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I spoke respectfully to adults and followed their requests without arguing or complaining.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I paid attention to my teacher or the assignment during class or work periods.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section I: General Classroom Behaviors Srudent Weekly Behavior Report Card Intermediate/Secondary Level Page 14
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I got along with others while behaving in a friendly and appropriate way.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I completed class assignments on time, applying my best effort.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I spoke respectfully to adults and followed their requests without arguing or complaining.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I paid attention to my teacher or the assignment during class or work periods.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Page 15
Section 2: Physical Aggression
(Set I)
Target Behaviors: l l l l
Bullies or is cruel toward other children.
Engages in rough, physical 'horse-play' when inappropriate.
Does not keep hands to self.
Threatens to hurt other students and/or staff members.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Teacher Daily Behavior Report Card Primary Level Page 16
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student treated others appropriately, and did not bully, threaten, or intimidate them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided engaging in rough, physical 'horse-play' with other students.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student kept hands to him/herself, not touching classmates or their property without permission.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student refrained from making physical threats against other students or staff members.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Teacher Weekly Behavior Report Card Primary Level Page 17
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student treated others appropriately, and did not bully, threaten, or intimidate them.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided engaging in rough, physical 'horse-play' with other students.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student kept hands to him/herself, not touching classmates or their property without permission.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student refrained from making physical threats against other students or staff members.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 18
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student treated others appropriately, and did not bully, threaten, or intimidate them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided engaging in rough, physical 'horse-play' with other students.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student kept hands to him/herself, not touching classmates or their property without permission.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student refrained from making physical threats against other students or staff members.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 19
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student treated others appropriately, and did not bully, threaten, or intimidate them.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided engaging in rough, physical 'horse-play' with other students.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student kept hands to him/herself, not touching classmates or their property without permission.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student refrained from making physical threats against other students or staff members.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Behavior Rating Report Card Monitoring Chart Page 20
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Srudent Daily Behavior Report Card Primary Level Page 21
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I treated others appropriately, and did not bully, threaten, or intimidate them.
1 2 3
Never/Seldom Sometimes Usually/Always
I did not take part in rough, physical 'horse-play' with other students.
1 2 3
Never/Seldom Sometimes Usually/Always
I kept my hands to myself, not touching classmates or their property without permission.
1 2 3
Never/Seldom Sometimes Usually/Always
I refrained from making physical threats against other students or staff members.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Srudent Weekly Behavior Report Card Primary Level Page 22
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I treated others appropriately, and did not bully, threaten, or intimidate them.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I did not take part in rough, physical 'horse-play' with other students.
1 2 3
Never/Seldom Sometimes Usually/Always
I kept my hands to myself, not touching classmates or their property without permission.
1 2 3
Never/Seldom Sometimes Usually/Always
I refrained from making physical threats against other students or staff members.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Srudent Daily Behavior Report Card Intermediate/Secondary Level Page 23
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I treated others appropriately, and did not bully, threaten, or intimidate them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I did not take part in rough, physical 'horse-play' with other students.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I kept my hands to myself, not touching classmates or their property without permission.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I refrained from making physical threats against other students or staff members.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 2: Physical Aggression I Srudent Weekly Behavior Report Card Intermediate/Secondary Level Page 24
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I treated others appropriately, and did not bully, threaten, or intimidate them.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I did not take part in rough, physical 'horse-play' with other students.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I kept my hands to myself, not touching classmates or their property without permission.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I refrained from making physical threats against other students or staff members.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Page 25
Section 3: Physical Aggression
(Set II)
Target Behaviors: l l l l
Destroys the property of others.
Has difficulty getting along with others.
Gets into physical fights with students.
Physically attacks adults and/or students.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Teacher Daily Behavior Report Card Primary Level Page 26
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student treated the property of other students and adults with care and respect.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student got along with others while showing socially appropriate behaviors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided getting involved in physical fights.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student interacted with adults and classmates without threatening the physical safety of self or others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Teacher Weekly Behavior Report Card Primary Level Page 27
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student treated the property of other students and adults with care and respect.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student got along with others while showing socially appropriate behaviors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided getting involved in physical fights.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student interacted with adults and classmates without threatening the physical safety of self or others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 28
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student treated the property of other students and adults with care and respect.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student got along with others while showing socially appropriate behaviors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided getting involved in physical fights.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student interacted with adults and classmates without threatening the physical safety of self or others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 29
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student treated the property of other students and adults with care and respect.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student got along with others while showing socially appropriate behaviors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided getting involved in physical fights.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student interacted with adults and classmates without threatening the physical safety of self or others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Behavior Rating Report Card Monitoring Chart Page 30
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Student Daily Behavior Report Card Primary Level Page 31
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I treated the property of other students and adults with care and respect.
1 2 3
Never/Seldom Sometimes Usually/Always
I got along with others while behaving in a friendly and appropriate way.
1 2 3
Never/Seldom Sometimes Usually/Always
I avoided getting involved in physical fights.
1 2 3
Never/Seldom Sometimes Usually/Always
I got along well with adults and classmates without threatening the physical safety of myself or anyone else
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Student Weekly Behavior Report Card Primary Level Page 32
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I treated the property of other students and adults with care and respect.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I got along with others while behaving in a friendly and appropriate way.
1 2 3
Never/Seldom Sometimes Usually/Always
I avoided getting involved in physical fights.
1 2 3
Never/Seldom Sometimes Usually/Always
I got along well with adults and classmates without threatening the physical safety of myself or anyone else
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Student Daily Behavior Report Card Intermediate/Secondary Level Page 33
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I treated the property of other students and adults with care and respect.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I got along with others while behaving in a friendly and appropriate way.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I avoided getting involved in physical fights.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I got along well with adults and classmates without threatening the physical safety of myself or anyone else
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 3: Physical Aggression II Student Weekly Behavior Report Card Intermediate/Secondary Level Page 34
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I treated the property of other students and adults with care and respect.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I got along with others while behaving in a friendly and appropriate way.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I avoided getting involved in physical fights.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I got along well with adults and classmates without threatening the physical safety of myself or anyone else
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Page 35
Section 4: Verbal Behaviors (Set I)
Target Behaviors: l l l l
Talks back to staff in a defiant manner.
Tells lies to students and/or staff.
Teases or mocks other students.
Blames others for own mistakes or actions.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Teacher Daily Behavior Report Card Primary Level Page 36
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student spoke respectfully and complied with adult requests without argument or complaint.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided saying things that were not true to classmates or adults.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was respectful of other students' feelings and avoided teasing them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took responsibility for his/her own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Teacher Weekly Behavior Report Card Primary Level Page 37
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student spoke respectfully and complied with adult requests without argument or complaint.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided saying things that were not true to classmates or adults.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was respectful of other students' feelings and avoided teasing them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took responsibility for his/her own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 38
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student spoke respectfully and complied with adult requests without argument or complaint.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided saying things that were not true to classmates or adults.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was respectful of other students' feelings and avoided teasing them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took responsibility for his/her own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 39
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student spoke respectfully and complied with adult requests without argument or complaint.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student avoided saying things that were not true to classmates or adults.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was respectful of other students' feelings and avoided teasing them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took responsibility for his/her own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Behavior Rating Report Card Monitoring Chart Page 40
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Student Daily Behavior Report Card Primary Level Page 41
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I spoke respectfully to adults and followed their requests without arguing or complaining.
1 2 3
Never/Seldom Sometimes Usually/Always
I told the truth to classmates or adults at all times.
1 2 3
Never/Seldom Sometimes Usually/Always
I was respectful of other students' feelings and avoided teasing them.
1 2 3
Never/Seldom Sometimes Usually/Always
I took responsibility for my own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Student Weekly Behavior Report Card Primary Level Page 42
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I spoke respectfully to adults and followed their requests without arguing or complaining.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I told the truth to classmates or adults at all times.
1 2 3
Never/Seldom Sometimes Usually/Always
I was respectful of other students' feelings and avoided teasing them.
1 2 3
Never/Seldom Sometimes Usually/Always
I took responsibility for my own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Student Daily Behavior Report Card Intermediate/Secondary Level Page 43
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I spoke respectfully to adults and followed their requests without arguing or complaining.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I told the truth to classmates or adults at all times.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I was respectful of other students' feelings and avoided teasing them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I took responsibility for my own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 4: Verbal Behaviors I Student Weekly Behavior Report Card Intermediate/Secondary Level Page 44
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I spoke respectfully to adults and followed their requests without arguing or complaining.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I told the truth to classmates or adults at all times.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I was respectful of other students' feelings and avoided teasing them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I took responsibility for my own mistakes or misbehaviors and did not attempt to shift blame onto others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Page 45
Section 5: Verbal Behaviors (Set II)
Target Behaviors: l l l l
Calls out or makes distracting noises in class.
Talks out of turn.
Swears or uses obscene language.
Interrupts others when they are speaking.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Teacher Daily Behavior Report Card Primary Level Page 46
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student was quiet during work or study periods, and did not make noise or call out.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited to be called on or given permission by the teacher before talking.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student used only appropriate language in all settings, and did not swear.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited his/her turn in discussions, and did not interrupt others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Teacher Weekly Behavior Report Card Primary Level Page 47
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student was quiet during work or study periods, and did not make noise or call out.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited to be called on or given permission to speak before talking.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student used only appropriate language in all settings, and did not swear.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited his/her turn in discussions, and did not interrupt others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 48
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student was quiet during work or study periods, and did not make noise or call out.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited to be called on or given permission to speak before talking.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student used only appropriate language in all settings, and did not swear.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited his/her turn in discussions, and did not interrupt others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 49
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student was quiet during work or study periods, and did not make noise or call out.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited to be called on or given permission to speak before talking.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student used only appropriate language in all settings, and did not swear.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student waited his/her turn in discussions, and did not interrupt others.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Behavior Rating Report Card Monitoring Chart Page 50
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Student Daily Behavior Report Card Primary Level Page 51
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I was quiet during work or study periods, and did not make noise or call out.
1 2 3
Never/Seldom Sometimes Usually/Always
I waited to be called on or given permission to speak before talking.
1 2 3
Never/Seldom Sometimes Usually/Always
I used appropriate language in all settings, and did not swear.
1 2 3
Never/Seldom Sometimes Usually/Always
I waited my turn when talking with others and did not interrupt them.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Student Weekly Behavior Report Card Primary Level Page 52
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I was quiet during work or study periods, and did not make noise or call out.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I waited to be called on or given permission to speak before talking.
1 2 3
Never/Seldom Sometimes Usually/Always
I used appropriate language in all settings, and did not swear.
1 2 3
Never/Seldom Sometimes Usually/Always
I waited my turn when talking with others and did not interrupt them.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Student Daily Behavior Report Card Intermediate/Secondary Level Page 53
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I was quiet during work or study periods, and did not make noise or call out.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I waited to be called on or given permission to speak before talking.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I used appropriate language in all settings, and did not swear.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I waited my turn when talking with others and did not interrupt them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 5: Verbal Behaviors II Student Weekly Behavior Report Card Intermediate/Secondary Level Page 54
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I was quiet during work or study periods, and did not make noise or call out.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I waited to be called on or given permission to speak before talking.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I used appropriate language in all settings, and did not swear.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I waited my turn when talking with others and did not interrupt them.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Page 55
Section 6: Inattentive/Hyperactive
Behaviors
Target Behaviors: l l l l
Displays a short attention span in the classroom.
Acts impulsively or without thinking.
Fidgets or squirms in seat during class or independent work.
Forgets instructions or directions.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Teacher Daily Behavior Report Card Primary Level Page 56
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student focused attention on teacher instructions, classroom lessons and assigned work.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student thought about the consequences of his/her actions before acting.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student sat in class without fidgeting or squirming more than peers.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remembered academic instructions and directions without needing extra reminders.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Teacher Weekly Behavior Report Card Primary Level Page 57
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student focused attention on teacher instructions, classroom lessons and assigned work.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student thought about the consequences of his/her actions before acting.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student sat in class without fidgeting or squirming more than peers.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remembered academic instructions and directions without needing extra reminders.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 58
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student focused attention on teacher instructions, classroom lessons and assigned work.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student thought about the consequences of his/her actions before acting.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student sat in class without fidgeting or squirming more than peers.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remembered academic instructions and directions without needing extra reminders.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 59
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student focused attention on teacher instructions, classroom lessons and assigned work.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student thought about the consequences of his/her actions before acting.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student sat in class without fidgeting or squirming more than peers.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student remembered academic instructions and directions without needing extra reminders.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Behavior Rating Report Card Monitoring Chart Page 60
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Student Daily Behavior Report Card Primary Level Page 61
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I was able to pay attention to teacher instructions, classroom lessons and assigned work.
1 2 3
Never/Seldom Sometimes Usually/Always
I took time to think about the consequences of my actions before acting.
1 2 3
Never/Seldom Sometimes Usually/Always
I sat in class without fidgeting or moving around too much.
1 2 3
Never/Seldom Sometimes Usually/Always
I remembered academic instructions and directions without needing extra reminders.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Student Weekly Behavior Report Card Primary Level Page 62
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I was able to pay attention to teacher instructions, classroom lessons and assigned work.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I took time to think about the consequences of my actions before acting.
1 2 3
Never/Seldom Sometimes Usually/Always
I sat in class without fidgeting or moving around too much.
1 2 3
Never/Seldom Sometimes Usually/Always
I remembered academic instructions and directions without needing extra reminders.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Student Daily Behavior Report Card Intermediate/Secondary Level Page 63
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I was able to pay attention to teacher instructions, classroom lessons and assigned work.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I took time to think about the consequences of my actions before acting.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I sat in class without fidgeting or moving around too much.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I remembered academic instructions and directions without needing extra reminders.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 6: Inattentive/Hyperactive Behaviors Student Weekly Behavior Report Card Intermediate/Secondary Level Page 64
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I was able to pay attention to teacher instructions, classroom lessons and assigned work.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I took time to think about the consequences of my actions before acting.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I sat in class without fidgeting or moving around too much.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I remembered academic instructions and directions without needing extra reminders.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Page 65
Section 7: Socially Withdrawn
Behaviors
Target Behaviors: l l l l
Clings to or is overly dependent on adults.
Fears going to school.
Is socially withdrawn, spending play- or free-time alone.
Is teased or bullied by other children.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Teacher Daily Behavior Report Card Primary Level Page 66
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student showed appropriate independence in the classroom and did not cling to adults.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student appeared relaxed, with little sign of anxiety/fear at being in school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was spontaneously included by peers in group work/play situations.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student's interactions with peers were friendly or neutral, without him/her being bullied or teased.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Teacher Weekly Behavior Report Card Primary Level Page 67
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student showed appropriate independence in the classroom and did not cling to adults.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student appeared relaxed, with little sign of anxiety/fear at being in school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was spontaneously included by peers in group work/play situations.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student's interactions with peers were friendly or neutral, without him/her being bullied or teased.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 68
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student showed appropriate independence in the classroom and did not cling to adults.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student appeared relaxed, with little sign of anxiety/fear at being in school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was spontaneously included by peers in group work/play situations.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student's interactions with peers were friendly or neutral, without him/her being bullied or teased.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 69
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student showed appropriate independence in the classroom and did not cling to adults.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student appeared relaxed, with little sign of anxiety/fear at being in school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student was spontaneously included by peers in group work/play situations.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student's interactions with peers were friendly or neutral, without him/her being bullied or teased.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Behavior Rating Report Card Monitoring Chart Page 70
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Student Daily Behavior Report Card Primary Level Page 71
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I was able to get along with students and do my work without a lot of help from the teacher.
1 2 3
Never/Seldom Sometimes Usually/Always
I felt relaxed in the classroom, and was not anxious or nervous about school.
1 2 3
Never/Seldom Sometimes Usually/Always
Other students invited me to join them in work groups or play groups.
1 2 3
Never/Seldom Sometimes Usually/Always
Other students were nice to me and did not bully me, pick on me, or tease me.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Student Weekly Behavior Report Card Primary Level Page 72
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I was able to get along with students and do my work without a lot of help from the teacher.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I felt relaxed in the classroom, and was not anxious or nervous about school.
1 2 3
Never/Seldom Sometimes Usually/Always
Other students invited me to join them in work groups or play groups.
1 2 3
Never/Seldom Sometimes Usually/Always
Other students were nice to me and did not bully me, pick on me, or tease me.
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Student Daily Behavior Report Card Intermediate/Secondary Level Page 73
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I was able to get along with students and do my work without a lot of help from the teacher.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I felt relaxed in the classroom, and was not anxious or nervous about school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Other students invited me to join them in work groups or play groups.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Other students were nice to me and did not bully me, pick on me, or tease me.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 7: Socially Withdrawn Behaviors Student Weekly Behavior Report Card Intermediate/Secondary Level Page 74
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I was able to get along with students and do my work without a lot of help from the teacher.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I felt relaxed in the classroom, and was not anxious or nervous about school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Other students invited me to join them in work groups or play groups.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Other students were nice to me and did not bully me, pick on me, or tease me.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work Related Behaviors Page 75
Section 8: School Work-Related
Behaviors
Target Behaviors: l l l l
Is unmotivated to apply effort on schoolwork.
Makes careless errors on assignments.
Fails to complete assigned classwork/homework.
Is unprepared for class (i.e., lacking work materials).
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Teacher Daily Behavior Report Card Primary Level Page 76
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student was motivated to work on class assignments/projects.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took care with school assignments, avoiding careless errors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed assigned classwork and homework.
1 2 3 4 5 6 7 8 9
None/Very Little Some Most/All
The student was prepared for class, with all necessary school materials (e.g., books, pencils, papers).
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Teacher Weekly Behavior Report Card Primary Level Page 77
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student was motivated to work on class assignments/projects.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took care with school assignments, avoiding careless errors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed assigned classwork and homework.
1 2 3 4 5 6 7 8 9
None/Very Little Some Most/All
The student was prepared for class, with all necessary school materials
(e.g., books, pencils, papers).
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 78
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
The student was motivated to work on class assignments/projects.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took care with school assignments, avoiding careless errors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed assigned classwork and homework.
1 2 3 4 5 6 7 8 9
None/Very Little Some Most/All
The student was prepared for class, with all necessary school materials (e.g., books, pencils, papers).
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 79
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
The student was motivated to work on class assignments/projects.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student took care with school assignments, avoiding careless errors.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
The student completed assigned classwork and homework.
1 2 3 4 5 6 7 8 9
None/Very Little Some Most/All
The student was prepared for class, with all necessary school materials
(e.g., books, pencils, papers).
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Behavior Rating Report Card Monitoring Chart Page 80
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Goal 1:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 2:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 3:
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
Most/All
Some
None/Very Little
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Most/All
Some
None/Very Little
M T W Th F M T W Th F M T W Th F M T W Th F
Goal 4:
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Student Daily Behavior Report Card Primary Level Page 81
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I worked hard and did my best on all class assignments/projects.
1 2 3
Never/Seldom Sometimes Usually/Always
I worked carefully on school assignments, avoiding careless errors.
1 2 3
Never/Seldom Sometimes Usually/Always
I finished and turned in all my classwork and homework assignments.
1 2 3
None/Very Little Some Most/All
I was prepared for class, with all necessary materials (e.g., books,paper).
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Student Weekly Behavior Report Card Primary Level Page 82
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I worked hard and did my best on all class assignments/projects.
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
I felt relaxed in the classroom, and was not anxious or nervous about school.
1 2 3
Never/Seldom Sometimes Usually/Always
I finished and turned in all my classwork and homework assignments.
1 2 3
None/Very Little Some Most/All
I was prepared for class, with all necessary materials (e.g., books,paper).
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Student Daily Behavior Report Card Intermediate/Secondary Level Page 83
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
I worked hard and did my best on all class assignments/projects.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I felt relaxed in the classroom, and was not anxious or nervous about school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I finished and turned in all my classwork and homework assignments.
1 2 3 4 5 6 7 8 9
None/Very Little Some Most/All
I was prepared for class, with all necessary materials (e.g., books,paper).
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 8: School Work-Related Behaviors Student Weekly Behavior Report Card Intermediate/Secondary Level Page 84
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
I worked hard and did my best on all class assignments/projects.
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I felt relaxed in the classroom, and was not anxious or nervous about school.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I finished and turned in all my classwork and homework assignments.
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
I was prepared for class, with all necessary materials (e.g., books,paper).
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Page 85
Section 9: Teacher-Selected
Behaviors
Target Behaviors: l l l l
First Teacher-Selected
Behavior
Second Teacher-Selected Behavior.
Third Teacher-Selected Behavior.
Fourth Teacher-Selected Behavior.
Resources in This Section: l l l l l
Teacher Daily Report Card: Primary Level
Teacher Weekly Report Card: Primary Level
Teacher Daily Report Card: Intermediate/Secondary Level
Teacher Weekly Report Card: Intermediate/Secondary Level
Progress-Monitoring Graph
----------------------------l l l l
Student Daily Report Card: Primary Level
Student Weekly Report Card: Primary Level
Student Daily Report Card: Intermediate/Secondary Level
Student Weekly Report Card: Intermediate/Secondary Level
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Teacher Daily Behavior Report Card Primary Level Page 86
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Behavior Goal 1: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Teacher Weekly Behavior Report Card Primary Level Page 87
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
Behavior Goal 1: __________________________________________________
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: __________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: _________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: _________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Teacher Daily Behavior Report Card Intermediate/Secondary Level Page 88
Teacher Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Behavior Goal 1: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: ___________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Teacher Weekly Behavior Report Card Intermediate/Secondary Level Page 89
Teacher Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
Behavior Goal 1: _________________________________________________
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: __________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: _________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: _________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Behavior Rating Report Card Monitoring Chart Page 90
Behavior Rating Report Card Monitoring Chart for __________________
Week of: _____ Week of: _____ Week of: _____ Week of: _____
Behavior Goal 1: _______________________________________________________________________
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Behavior Goal 2: ________________________________________________________________________
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Behavior Goal 3: _______________________________________________________________________
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Behavior Goal 4: ________________________________________________________________________
Usually/Always
Sometimes
Never/Seldom
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
9
8
7
6
5
4
3
2
1
Usually/Always
Sometimes
Never/Seldom
M T W Th F M T W Th F M T W Th F M T W Th F
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Srudent Daily Behavior Report Card Primary Level Page 91
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Behavior Goal 1: I__________________________________________________________________
1 2 3
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: I__________________________________________________________________
1 2 3
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: I__________________________________________________________________
1 2 3
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: I__________________________________________________________________
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Srudent Weekly Behavior Report Card Primary Level Page 92
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
Behavior Goal 1: _________________________________________________
Mon Tues Wed Thurs Fri
1 2 3
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: _________________________________________________
1 2 3
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: _________________________________________________
1 2 3
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: _________________________________________________
1 2 3
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Srudent Daily Behavior Report Card Intermediate/Secondary Level Page 93
Student Daily Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Behavior Goal 1: I__________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: I__________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: I__________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: I__________________________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org
Section 9: Teacher-Selected Behaviors Srudent Weekly Behavior Report Card Intermediate/Secondary Level Page 94
Student Weekly Behavior Report Card
Student:___________________ Date:__________________
Teacher: __________________ Classroom: _____________
Directions: Please rate the student each day on the behavioral items below:
Student Behavioral Goals
Behavior Goal 1: _________________________________________________
Mon Tues Wed Thurs Fri
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 2: _________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 3: _________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Behavior Goal 4: _________________________________________________
1 2 3 4 5 6 7 8 9
Never/Seldom Sometimes Usually/Always
Classroom Behavior Report Card Resource Book www.interventioncentral.org